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In this episode of “What the Health?” Julie Rovner of Kaiser Health News, Margot Sanger-Katz of The New York Times, Sarah Kliff of Vox.com and Alice Ollstein of Talking Points Memo discuss this year’s open enrollment for individual health insurance that starts Nov. 1. And Rovner interviews Lori Lodes, a former Obama administration health official and founder of the new group “Get Covered America.” Plus, for “extra credit,” the panelists recommend their favorite health stories of the week.
(10/26)

During Northern California’s recent wildfires, dozens of hospice patients who had hoped to spend their last days in the comfort of their homes had to be relocated to evacuation shelters, assisted living facilities and relatives’ homes instead. (April Dembosky, KQED,
10/27)

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Summaries Of The News:

Instead, President Donald Trump declared the epidemic a public health emergency, which is more limited status in terms of what federal and state officials can do to address the problem. Media outlets take a look at what exactly the move entails.

The New York Times:
Trump Declares Opioid Crisis A ‘Health Emergency’ But Requests No Funds
President Trump on Thursday directed the Department of Health and Human Services to declare the opioid crisis a public health emergency, taking long-anticipated action to address a rapidly escalating epidemic of drug use. But even as he vowed to alleviate the scourge of drug addiction and abuse that has swept the country — a priority that resonated strongly with the working-class voters who supported his presidential campaign — Mr. Trump fell short of fulfilling his promise in August to declare “a national emergency” on opioids, which would have prompted the rapid allocation of federal funding to address the issue. (Davis, 10/26)

The Hill:
Trump Says This Can Be Generation That Ends Opioid Epidemic
"Nobody has seen anything like this going on now. As Americans, we cannot allow this to continue," Trump said at a White House ceremony alongside advocates and his wife, Melania. "It is time to liberate our communities from this scourge of drug addiction. ... We can be the generation that ends the opioid epidemic. We can do it," he said to long, thunderous applause. (Roubein and Hellmann, 10/26)

The Washington Post:
Trump Declares Opioid Crisis A Public Health Emergency; Critics Say Plan Falls Short
With Trump’s declaration, the federal government will waive some regulations, give states more flexibility in how they use federal funds and expand the use of telemedicine treatment, according to senior administration officials. But the president stopped short of declaring a more sweeping national state of emergency that would have given states access to funding from the federal Disaster Relief Fund, as they would after a tornado or hurricane. Officials who briefed reporters said that such an emergency declaration would not be a good fit for a longtime crisis and would not offer authorities that the government doesn’t already have. (Wagner, Bernstein and Johnson, 10/26)

Politico:
Trump's Call To Bolster Virtual Opioid Treatment Lacks Muscle, Critics Say
The first item in Trump’s public health emergency declaration was to use telemedicine — video and phone-enabled communications with doctors, pharmacists and nurses — to remotely prescribe drugs for substance abuse and mental illness. Under a 2008 law, doctors have been barred from prescribing anti-addiction medications to patients they haven’t seen in person first. The law created a barrier for addicts in rural, doctor-starved places that have been hit hardest by the crisis — and that voted for Trump in droves last November. (Pittman, 10/26)

Bloomberg:
Trump Declares Opioid Addiction A Public Health Emergency
Trump also said he would use the federal government’s legal powers to pursue companies that helped fuel the epidemic. "We will be bringing some very major lawsuits against people and against companies that are hurting our people," Trump said in a speech at the White House on Thursday. (Talev, Hopkins and Edney, 10/26)

Stat:
Naloxone Is Missing Puzzle Piece In Trump Opioid Plan, Advocates Say
[Trump's] announcement included nothing about access to naloxone, the overdose-reversal drug that first responders across the country have credited with saving innumerable lives. “I think this was a missed opportunity,” said Regina LaBelle, the chief of staff for the Office of National Drug Control Policy under former president Barack Obama. “They could have purchased naloxone and distributed it to hard-hit areas, to local governments as well as to community groups.” (Facher and Joseph, 10/26)

The Associated Press:
Trump Calls For Liberation From 'Scourge' Of Drug Addiction
Trump's declaration, which will be effective for 90 days and can be renewed, will allow the government to redirect resources in various ways and to expand access to medical services in rural areas. But it won't bring new dollars to fight a scourge that kills nearly 100 people a day. "As Americans we cannot allow this to continue," Trump said in a speech Thursday at the White House, where he bemoaned an epidemic he said had spared no segment of society, affecting rural areas and cities, rich and poor and both the elderly and newborns. (Colvin and Johnson, 10/27)

The Washington Post:
How The Government Can Fight The Opioid Epidemic Under A Public Health Emergency
At this point in the nation's opioid epidemic, fighting back is mainly about quickly making money available: Money for treatment. Money for the overdose antidote naloxone. Money to hire more people to help overwhelmed cities and states battle a crisis that killed an estimated 64,000 Americans last year. President Trump did not identify any big new sources of funding when he declared the situation a public health emergency Thursday afternoon. But his official pronouncement will help the government speed any available resources to communities, where the epidemic is playing out on the streets every day, and will eliminate some obstacles that stand in the way of providing assistance. (Bernstein, 10/26)

The New York Times:
The Opioid Crisis: An Epidemic Years In The Making
The current opioid epidemic is the deadliest drug crisis in American history. Overdoses, fueled by opioids, are the leading cause of death for Americans under 50 years old — killing roughly 64,000 people last year, more than guns or car accidents, and doing so at a pace faster than the H.I.V. epidemic did at its peak. (Salam, 10/26)

The past and future role of Trump family members on the president's action is in the spotlight —

The Washington Post:
‘I Learned Because Of Fred’: Trump Cites Brother’s Struggle In Talking About Addiction
President Trump stood in the White House’s grandly decorated East Room on Thursday afternoon and read from a teleprompter as he explained how his administration will launch “a massive advertising campaign” to tell children to never try drugs. Then the teleprompter halted as the president went off script.“I learned myself. I had a brother, Fred. Great guy, best-looking guy, best personality — much better than mine,” Trump said, as those gathered in the room, many of whom have lost loved ones to the opioid crisis, laughed at the overly confident president’s rare jab at himself. “But he had a problem. He had a problem with alcohol. And he would tell me: ‘Don’t drink. Don’t drink.’ ” (Johnson, 10/26)

The Hill:
Melania Trump Commits To Fighting Opioid Crisis
First lady Melania Trump made a rare public appearance Thursday to express her commitment to fighting the opioid crisis. "I have learned so much from those and I know there are many more stories to tell," Trump said at a White House event declaring the opioid crisis a public health emergency." (Hellmann, 10/26)

While some criticize the lack of money behind the Trump administration's public health emergency move, others are excited for the light it will shine on the opioid epidemic.

The Wall Street Journal:
Trump’s Opioid-Crisis Declaration Draws Praise, Criticism
Officials and activists on the front lines of the opioid crisis split Thursday over President Donald Trump’s designation of a “public health emergency,” with some praising it as a necessary move and others saying more money is needed. Ryan Hampton, a national recovery activist in Pasadena, Calif., who is personally recovering a struggle with opioids, called the president’s announcement “a welcome step in the right direction” but also said the president’s words require funding support. “The big, open-ended question, though, is will there be follow through, will there be action?” Mr. Hampton said. (Kamp and Mahtani, 10/26)

The Hill:
Advocates Pan Trump Effort On Opioid Crisis
Advocates for greater opioid treatment panned the president’s long-awaited declaration of a public health emergency, saying they need dollars to fight the epidemic killing tens of thousands of Americans every year. President Trump’s declaration, promised in August, doesn't include millions in new federal funding. Nor did it ask Congress to appropriate any new money, and Democrats are calling for tens of billions in more funds. (Roubein and Weixel, 10/26)

NPR:
'They Need Help': Trump Faces Backlash For Slow Response To Opioid Crisis
The president's announcement gives states more leeway to spend federal money in response to the rise in drug overdose deaths. It also broadens the reach of medical services in rural areas. "I think declaring an emergency is important, but it is not going to make much difference if we don't actually put resources towards this public health crisis," says Sen. Claire McCaskill, D-Mo. (Raphelson, 10/26)

CQ:
Trump Declares Opioid Emergency, But Future Funding Unclear
“Where would this money come from? That’s really the point,” said Minority Leader Nancy Pelosi, D-Calif. “Are we talking cannibalizing other aspects of the health care in our country?” In some respects, the public health emergency declaration could do just that. State employees with jobs funded by federal dollars usually have specific job descriptions, but the emergency declaration could make it possible for states to reassign them to focus on opioid prevention and treatment. The declaration would also allow states to use some of about $2.3 billion for HIV/AIDS programs and refocus it to prioritize the many HIV/AIDS patients who have co-occurring opioid use disorders. (Siddons and Rahman, 10/26)

The Hill:
NH Dems Say Money Must Be Provided For Opioid Declaration
New Hampshire Sens. Maggie Hassan (D) and Jeanne Shaheen (D) are calling on President Trump to pledge financial resources to combat the widespread opioid crisis, as he moves to declare the epidemic a public health emergency. "I'm pleased he's designated this as a public health emergency, but I really want to see the resources that need to come in order for our communities and families in New Hampshire to be able to fight this horrible disease," Shaheen said on MSNBC's "Andrea Mitchell Reports," in a joint interview with Hassan on Thursday. (Beavers, 10/26)

Stat:
Markey’s $45 Billion Proposal For Opioid Treatment Has A Familiar Ring To It
The Trump administration’s announcement that it would declare the opioid crisis a public health emergency on Thursday begged an immediate question: Where’s the money to back it up? Sen. Ed Markey (D-Mass.) has a plan with an unlikely source. “Republicans are onto a very good idea in adding $45 billion to provide additional care and treatment for opioid patients,” he said, referring to a bill he introduced on Wednesday with Sen. Bob Casey (D-Pa.) and 13 other Democrats. (Facher, 10/26)

NPR:
Trump Administration Declares Opioid Crisis A Public Health Emergency
Dr. Andrew Kolodny, co-director of the Opioid Policy Research Collaboration at Brandeis University's Heller School, calls the announcement "very disappointing." Without funding for new addiction treatment, he says, declaring a public health emergency isn't enough. "This is not a plan," he says. "The administration still has no plan" for dealing with opioids, he says. (Allen and Kelly, 10/26)

Modern Healthcare:
No New Funding In Trump's Emergency Opioid Declaration
Overall the declaration was seen helping raise public awareness. "We strongly support President Trump's decision to officially label the opioid epidemic a public health emergency," said Rep. David McKinley (R-WV) in an emailed statement. "As ground zero for this public health emergency, it is time West Virginia received the resources it deserves, and today's action is a big step towards accomplishing that." "Really, he's going to be asking the entire government to get behind this effort," said Tom Coderre, senior adviser at the Altarum Institute and a former chief of staff and senior adviser to the Assistant Secretary at SAMHSA during the Obama administration. "That's the bigger message of today, but certainly the devil is always in the details." (Johnson, 10/26)

The Hill:
Christie: Trump's Opioid Declaration 'Exactly What We Asked For'
New Jersey Gov. Chris Christie (R) on Thursday praised President Trump’s decision to declare the opioid epidemic a public health emergency, calling it “exactly what we asked for.” “The president, what he did today gives this Cabinet and the executive branch of this government every bit of authority they need to do whatever it is they want to do in concert with Congress to be able to do what needs to be done,” Christie told CNN following a ceremony at the White House. (Samuels, 10/26)

The emergency declaration “falls far short of actions that are needed to immediately address the magnitude and scope of this epidemic,” says Michael Botticelli, executive director of the Grayken Center for Addiction at Boston Medical Center. Media outlets cover reactions out of Pennsylvania, Ohio, California, Illinois and Virginia as well.

Boston Globe:
Declaring An Emergency Sounds Good — But People In Mass. Ask, Where Are The Dollars?
Addiction specialists and advocates in Massachusetts, one of the states hardest hit by the opioid epidemic, welcomed President Trump’s words Thursday declaring a public health emergency — but decried the lack of money and actions to back them up. “It’s disgraceful,” said Kurt Isaacson, CEO of Spectrum Health Systems, a nonprofit addiction-treatment provider based in central Massachusetts. “If you’re just talking about something, and you’re not doing anything actionable, then the words are kind of hollow.” (Freyer, 10/26)

WBUR:
Trump's Declaration Of Opioid Epidemic As Public Health Emergency Gets Mixed Reviews In Mass.
Gov. Charlie Baker, who is a member of Trump's opioid commission, said the emergency declaration is a "strong step in the right direction," but he's calling on the White House and Congress to fully fund the commission's recommendations. Speaking at an event in Lawrence Thursday, the Republican governor said he is eager for next week's release of the White House commission's final report and thinks that national leaders should do what was done in Massachusetts. (Becker, 10/26)

The Philadelphia Inquirer/Philly.com:
In Philly Region, Trump's Opioid Statement Prompts Hope, Skepticism
In the Philadelphia region, where thousands die each year of drug overdoses, President Trump’s declaring the opioid crisis a public health emergency was greeted Thursday with some wary hope and plenty of skepticism. All agreed that until more details are revealed, it’s hard to know what the statement will mean locally.“I hope it’s not just words – that there’s actions behind it,” said Mayor Kenney, adding that “presidential acknowledgment of the problem nationwide is important.” But designating the situation a national emergency, he noted, would have meant more federal money for treatment and housing for homeless drug users. (Schaefer, 10/26)

Columbus Dispatch:
Trump Declares Health Emergency On Drugs, But No Money
Ohio and other states could benefit from Trump’s move to lift a Medicaid requirement that limited drug treatment centers to no more than 16 beds. Cheri Walter, CEO of the Ohio Association of County Behavioral Authorities, said easing that regulation would help.“It’s going to make beds available for the opioid epidemic very quickly,” she said. “And a lot of people are in need of services, particularly in a residential-type setting.” (Wehrman, 10/26)

San Jose Mercury News:
How Does California Fit Into The Opioid Crisis?
While states like West Virginia, Ohio and New Hampshire have carved out unenviable reputations in the headlines as bastions of prescription painkiller abuse, California has hardly been spared the ravages of this public-health crisis: more than 183,000 deaths in the state from 1999 through 2015 have been attributed to the epidemic. ... So how does California compare? From the California Department of Public Health and its Opioid Overdose Surveillance Dashboard, here are some numbers that paint a troubling picture for the state as the president declares war on the crisis. (May, 10/26)

Chicago Tribune:
Chicago Suffers Under Fentanyl's Toll As President Declares Opioid Emergency
Chicago has long been one of the nation’s biggest heroin markets, but the introduction of powerful synthetic opioids such as fentanyl and carfentanil into the street trade has had a devastating effect on overdose deaths, experts say. Drug dealers often add synthetics to heroin — or substitute them for heroin altogether — to create a more potent and alluring high, but stronger-than-expected doses can be lethal. (Keilman, 10/26)

The effort is designed to see what regulations are getting in the way of doctors' ability to spend time with patients. In other industry news, some hospitals and doctors that once complained about requirements for bundled payments are revising their assessments, and an experiment to keep nursing home residents out of the hospital is showing promise.

Modern Healthcare:
CMS Wants Docs To Spend More Time On Patients, Less On Paperwork
The CMS launched an initiative Thursday to help it determine what provider regulations it should junk or revamp, citing growing concerns that its regulations are reducing the time providers spend with patients. As part of the Patient over Paperwork initiative, CMS officials will travel the country to gather information on the impact their regulations have on physicians. Those conversations have been taking place informally for weeks. The outreach effort comes at a time that primary-care physicians are spending 27% of their time on clinical activities and 49% on administrative activities, according to a 2016 Annals of Internal Medicine study. (Dickson, 10/26)

Modern Healthcare:
Hospitals Warm Up To CMS Bundled Payments As Agency Cools Off On Them
Jon Fohrer was not at all happy last year that the CMS required all hospitals in the Indianapolis market to participate in its bundled-payment program for total hip and knee replacement procedures on Medicare patients. The five-year demonstration, launched by the CMS Innovation Center in 2016 to speed the shift to value-based payment, was controversial among hospital leaders and surgeons because it was mandatory for all hospitals in 67 markets across the country. ... That was then. Fohrer's attitude, like the views of other hospital leaders about the CJR program, has changed dramatically since. New CMS data shows that many hospitals have succeeded in meeting the program's challenging requirements and have received financial rewards. (Meyer, 10/26)

Modern Healthcare:
CMS Experiment Saves Millions, Decreases Hospital Visits
The CMS has seen a drop in avoidable hospitalizations of seniors and generated nearly $50 million in savings from an experiment that aimed to keep nursing home residents out of inpatient care. The agency recently touted the results of its three-year Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents, which saw a 17% relative reduction in potentially avoidable hospitalizations in participating facilities. (Dickson, 10/26)

In nearly all of the 2,722 counties included in a recent report, some consumers will be able to obtain free health insurance because they qualify for larger federal premium subsidies that cover the full cost of a plan now that President Donald Trump has stopped cost-sharing payments to insurers. In other health law news: what the marketplaces are going to be like for consumers this year; navigator funding; what Americans want the path forward to be; and more.

The Wall Street Journal:
More ACA Plans To Come With No Premiums In 2018
Insurers selling Affordable Care Act plans have a compelling new pitch: free health insurance. When sales of plans on the law’s exchanges begin Nov. 1, a growing number of consumers around the country will be able to get coverage for 2018 without paying any monthly premium, according to health insurers and an analysis of newly available federal data. (Wilde Mathews and Weaver, 10/27)

The Hill:
Trump's ObamaCare Move May Bolster Law
President Trump’s decision to cancel key ObamaCare payments could be backfiring. Trump has claimed the health law is “imploding,” and earlier this month he took an action seemingly aimed at that goal: cutting off key payments to insurers known as cost-sharing reductions. (Sullivan, 10/27)

The Washington Post:
What It’s Like To Look For Health Insurance Now That Trump Has Tried To Undermine Obamacare
Cindy Purvance of Park City, Utah, was incensed when she received a letter in the mail alerting her that her family’s health insurance premium would skyrocket to $1,300 a month next year — a $500 increase. Purvance vented on social media, called her insurance company and eventually consulted with an expert who helps people sign up for health plans. She learned something counterintuitive: She would probably see a smaller increase if she bought the same kind of plan she currently has — but off the Affordable Care Act exchange. (Johnson, 10/26)

NPR:
Some States Face Hard Choices After Federal Health Navigator Funds Are Slashed
Despite all of the efforts in Congress to repeal and replace the Affordable Care Act this year, it remains the law of the land. People can start signing up for health insurance for 2018 starting Nov. 1. But the landscape for the law has changed a lot. Take navigators, for instance. Those are specially trained people who help consumers sign up for coverage. In August, the Centers for Medicare & Medicaid Services cut funding for navigators by 41 percent. (Olgin, 10/26)

Reuters:
Americans Want To See A Bipartisan Fix For Obamacare: Reuters/Ipsos Poll
As Republican and Democratic lawmakers clash over the future of Obamacare, Americans largely are eager for a bipartisan solution to its shortcomings, according to a Reuters/Ipsos opinion poll released on Thursday. The Oct. 14-23 poll found that 62 percent of Americans want former President Barack Obama's healthcare law to be maintained, up from 54 percent in a January poll. About half – including 51 percent of Democrats and 56 percent of Republicans – want "a bipartisan group" rather than just members of their own parties to improve the healthcare system. (Mincer and Kahn, 10/26)

Kaiser Health News:
What The Health? Open Enrollment Is Nigh
Despite the best efforts of President Donald Trump and the GOP-led Congress, the Affordable Care Act is still the law of the land. And after a turbulent year, open enrollment for individuals who buy their own health insurance begins Nov. 1 and ends Dec. 15. (10/26)

California Healthline:
Acute Confusion As Exchange Enrollment Nears
If the comments on Covered California’s Facebook page are any indication, you’re all suffering from acute health insurance confusion. ... I don’t blame you. Choosing a health plan will be doubly hard this year given President Donald Trump’s recent move to cut off federal payments for a key consumer subsidy, his administration’s decision to shorten exchange open-enrollment periods in most states to 45 days, Congress’ failed attempts to repeal Obamacare and the departure of some insurers from certain markets. (Bazar, 10/27)

KCUR:
Good News And Bad News For Missourians Buying Marketplace Health Plans For 2018
There’s some good news and some bad news for Missourians purchasing marketplace healthcare plans under the Affordable Care Act. The good news: Those eligible for premium subsidies will see no increase in their premiums. In fact, a 40-year-old non-smoker earning $30,000 a year will see a 2.7 percent reduction of his or her premiums to $201 a month. The bad news: Those not eligible for subsidies will see premium increases ranging from 12 percent to 50 percent for the benchmark silver plan. (Margolies, 10/26)

Roll Call:
House GOP Leaders Announce Children’s Health Insurance Vote
Arguments erupted on the House floor Thursday between Republican and Democratic leaders over the prospect of a vote next week on a GOP-only bill to renew funding for the Children’s Health Insurance Program. House Majority Whip Kevin McCarthy, R-Calif., announced the bill would be debated next week — a plan opposed by Minority Whip Steny H. Hoyer, D-Md. Democrats have pushed to delay the House bill until an agreement is reached on a bipartisan solution to pay for it. (Raman, 10/26)

The deal reflects a blurring of traditional boundaries in health care as companies try to adjust to the ever-changing and uncertain marketplace.

The New York Times:
CVS Is Said To Be In Talks To Buy Aetna In Landmark Acquisition
CVS Health, the giant drugstore chain that also runs walk-in clinics and a pharmacy benefit business, is in talks to buy Aetna, one of the nation’s largest health insurance companies, according to people briefed on the talks. Negotiations between the two companies could still fall apart, these people say. But if consummated, the deal could be worth more than $60 billion based on Aetna’s current market value, which would make it one of the largest corporate acquisitions this year and one of the largest in the history of the health industry. (Sorkin, de la Merced and Thomas, 10/26)

The Wall Street Journal:
CVS Makes Blockbuster Aetna Bid
CVS Health Corp. is in talks to buy Aetna Inc. for more than $66 billion as the drugstore giant scrambles to fortify itself against looming competition from Amazon.com Inc. amid a continuing reordering of the health-care industry. CVS has made a proposal to buy the health insurer for more than $200 per share, people familiar with the matter said. The talks may not lead to a deal, but in a sign of their seriousness, the companies’ respective chief executives— Larry Merlo at CVS and Mark Bertolini at Aetna—have met multiple times over a period of roughly six months, one of the people said. (Mattioli, Terlep and Wilde Mathews, 10/26)

The Wall Street Journal:
The Real Reason CVS Wants To Buy Aetna? Amazon
Amazon.com Inc. has struck again. Only this time the internet giant is shaking up an industry it hasn’t yet entered. Amazon’s potential entry into the pharmacy-services industry helped spur CVS Health Corp.’s $66 billion bid for insurance giant Aetna Inc., AET 11.54% according to a person familiar with the matter. An acquisition of a major insurer was among roughly a dozen strategies CVS’s management team recently presented to directors, the person said. (Terlep and Stevens, 10/27)

Bloomberg:
Amazon Threat Causes Shakeout In The Health-Care Industry
Amazon.com Inc. is casting a long shadow over the health-care industry. The prospect of the giant Internet retailer entering the business is beginning to cause far-reaching reverberations for a range of companies, roiling the shares of drugstore chains, drug distributors and pharmacy-benefit managers, and potentially precipitating one of the biggest corporate merger deals this year. On Thursday, the pressure was plain to see. A report that Amazon had received pharmacy-wholesaler licenses in a dozen states triggered a fast and steep selloff that wounded the likes of McKesson Corp., AmerisourceBergen Corp. and Cardinal Health Inc. And late in the day, shares of Aetna Inc. surged after a report that it was in talks to be taken over by CVS Health Corp. (Langreth, Hopkins and Soper, 10/26)

The Hill:
Amazon Gets Pharmacy Licenses In At Least 12 States: Report
Tech giant Amazon is expanding into the pharmacy business, according to a Thursday report from the St. Louis Post-Dispatch. The popular shopping website has allegedly received approval for wholesale pharmacy licenses in at least 12 states: Nevada, Arizona, North Dakota, Louisiana, Alabama, New Jersey, Michigan, Connecticut, Idaho, New Hampshire, Oregon and Tennessee. (Bowden, 10/26)

St. Louis Post Dispatch:
Amazon Gains Wholesale Pharmacy Licenses In Multiple States
Throughout the past year, and without much fanfare, Amazon.com Inc. has gained approval to become a wholesale distributor from a number of state pharmaceutical boards, according to a review of public records. It’s unclear, though, whether the regulatory filings support speculation that the e-commerce giant is planning a move into the prescription drug delivery business, territory currently dominated by a handful of companies. (Liss, 10/27)

Bloomberg:
Aetna Rises After WSJ Reports CVS In Talks To Buy Insurer
Aetna Inc. gained in New York trading after the Wall Street Journal reported that CVS Health Corp. is in talks to buy the insurer for more than $66 billion. Aetna jumped 12 percent to $178.60, closing at a record high, while CVS fell 2.9 percent to $73.31. Spokesmen for Aetna and CVS declined to comment. CVS has offered to buy Aetna for more than $200 a share, the paper said. (Tracer and Langreth, 10/26)

The company, which provides software to businesses in hopes of selling them health-insurance plans, made false statements to investors about whether its employees were properly licensed, according to the Securities and Exchange Commission.

The Wall Street Journal:
Health-Benefits Broker Zenefits, Co-Founder Conrad Settle With SEC
Health-benefits broker Zenefits and its co-founder Parker Conrad have settled charges brought by the U.S. Securities and Exchange Commission that they misled investors, the regulator said Thursday. Zenefits will pay a $450,000 penalty and Mr. Conrad will pay $534,000 to settle the charges without admitting or denying the findings that they violated securities laws. The SEC charged that the company and Mr. Conrad made false statements to investors about whether its employees were properly licensed to sell insurance. The company offers businesses free human-resources software in hopes of selling them health-insurance plans. (Winkler, 10/26)

Reuters:
Zenefits And Co-Founder Parker Conrad To Pay SEC Fine Of Nearly $1 Million
Silicon Valley business software startup Zenefits and its co-founder Parker Conrad have been fined nearly $1 million by the U.S. Securities and Exchange Commission as part of a settlement over charges that they misled investors. Zenefits will pay a $450,000 penalty and Conrad, who resigned as the company's chief executive in early 2016, will pay more than $533,000 to settle charges that the company lied about its compliance with state insurance regulations. (Somerville, 10/26)

Prosecutors allege John N. Kapoor had been bribing doctors to prescribe his company's drug intended for cancer patients only.

The Washington Post:
Former Executive Charged With Conspiring To Illegally Distribute Fentanyl
The founder of an Arizona-based pharmaceutical company has been charged with spearheading a “nationwide conspiracy” to illegally distribute fentanyl, a powerful prescription painkiller. John N. Kapoor, 74, was charged with numerous felonies, including RICO (Racketeer Influenced and Corrupt Organization) conspiracy and wire fraud. Prosecutors allege Kapoor, the founder of Insys Pharmaceuticals, colluded with doctors and pharmacies to prescribe fentanyl that was not medically necessary and defraud insurance companies for payment. (Zezima, 10/26)

The Associated Press:
Drug Company Founder Indicted In US-Wide Opioid Conspiracy
The case naming Kapoor follows indictments against the company’s former CEO and other executives and managers on allegations that they provided kickbacks to doctors to prescribe a potent opioid called Subsys. In the new indictment, Kapoor, 74, of Phoenix, and the other defendants are accused of offering bribes to doctors to write large numbers of prescriptions for the fentanyl-based pain medication that is meant only for cancer patients with severe pain. Most of the people who received prescriptions did not have cancer. (Snow and Davenport, 10/26)

Reuters:
U.S. Attorney General Says People Should Just 'Say No' To Opioids
U.S. Attorney General Jeff Sessions equated the opioid epidemic to a personal failing by many Americans who cannot "say no" to drugs on Thursday, and he said that marijuana could be serving as a gateway to the problem. "People should say no to drug use. They have got to protect themselves first," he said during a question-and-answer session at the Heritage Foundation think tank in Washington. (Lynch, 10/26)

The Hill:
Overdose Deaths Have Doubled In A Decade
The number of Americans dying from drug overdoses jumped by more than 200 percent in the last 16 years, a spike that crosses economic, geographic and racial lines. More than 52,000 Americans died of a drug overdose in 2015, according to the Centers for Disease Control and Prevention. That’s 211 percent higher than the 16,849 people who died of overdoses in 1999 and double the 25,785 who died that way in 2003. (Wilson, 10/26)

Bloomberg:
Lawsuits Won't Fix Opioid Epidemic, Top Drug Distributor Says
Courtrooms aren’t the place to fix the opioid epidemic, said a top drug distributor targeted by numerous lawsuits from cities and states claiming it played a role in the crisis. “Frankly, lawsuits from various parties and settlements don’t solve the problem,” said John Hammergren, the chief executive of McKesson Corp., in discussing quarterly results on a call with analysts Thursday. “What solves the problem is thinking in a broader context and putting the solutions in place that they can actually prevent this from happening.” (Hopkins, 10/26)

NPR:
Narcan Opioid Overdose Spray Is Now Stocked By All Walgreens Pharmacies
It has the power to save lives by targeting opioid overdoses — something that kills more than 140 Americans every day. And now Narcan, the nasal spray that can pull a drug user back from an overdose, is being carried by all of Walgreens' more than 8,000 pharmacies. "By stocking Narcan in all our pharmacies, we are making it easier for families and caregivers to help their loved ones by having it on hand in case it is needed," said Walgreens vice president Rick Gates. (Chappell, 10/26)

Miami Herald:
Police Departments To Take Back Unwanted Prescription Drugs
Have unwanted or unused prescription drugs taking up room in your medicine cabinet? Police departments across South Florida are taking part in the Drug Enforcement Administration's National Prescription Drug Take-Back Day from 10 a.m. to 2 p.m. Saturday. That means people can drop off prescription drugs with no questions asked. (Teproff, 10/26)

The findings are the latest in a growing body of evidence suggesting that time of day plays an important role in how well various medical treatments work. In other public health news: controversy continues over whether someone who is overweight can be healthy; the benefits of being a do-gooder; stem cell treatments; and the link between marijuana and sex.

Stat:
Why Having Surgery Later In The Day Might Be Better For Your Health
The time of day of your surgery could have long-term impacts on your health. That’s according to researchers who looked at the way circadian rhythm — the body’s internal clock — affects the outcomes of a patient recovering from a complex heart procedure. Patients who underwent open-heart surgery in the afternoon experienced better health outcomes compared to those who got operated on in the morning, study authors found after six years of observing nearly 600 patients who underwent heart valve replacement. In the subsequent 500 days after surgery, researchers found, those patients who had surgery after noon had half the risk of a major cardiac event — for instance myocardial infarction, acute heart failure, or death — as those who had surgeries before then. (Blau, 10/26)

The New York Times:
‘Fat But Fit’? The Controversy Continues
Can you be fit and healthy, even if you’re overweight? And will working out, despite the extra pounds, reduce your risk of a heart attack? The idea that you can be “fat but fit” has long been controversial. While health experts endorse physical activity as beneficial, many doctors view the concept of being “fat but fit” with suspicion. (Rabin, 10/26)

The New York Times:
Why Doing Good Is Good For The Do-Gooder
The past few months, with a series of disasters seemingly one on top of another, have felt apocalyptic to many, but the bright side to these dark times has been the outpouring of donations and acts of generosity that followed. From Hurricane Harvey flooding Houston to Hurricanes Irma and Maria ripping through the Caribbean to wildfires burning Northern California, cities and charities have been flooded with donations and volunteers. The outpouring of support is critical for helping affected communities to recover. But acts of generosity benefit the do-gooder, too. (Karlis, 10/26)

KQED:
Paralyzed Patients Regain Movement In Stem Cell Trial: Is It Too Early To Celebrate?
If you’ve been reading about the SCiStar stem cell trial, you know the company’s reports of its initial results sound truly remarkable. The trial is injecting oligodendrocyte progenitor cells, produced from human embryonic stem cells, into patients ages 18-69. These trial subjects have suffered recent spinal cord injuries in the neck, resulting in the loss of nearly all sensation and movement below the injury, as well as some paralysis of the arms and legs. (Gorn, 10/26)

NPR:
Researchers Find Frequency Of Sex Rises With Marijuana Use
Tobacco companies put a lot of effort into giving cigarettes sex appeal, but the more sensual smoke might actually belong to marijuana.Some users have said pot is a natural aphrodisiac, despite scientific literature turning up mixed results on the subject. At the very least, a study published Friday in the Journal of Sexual Medicine suggests that people who smoke more weed are having more sex than those who smoke less or abstain. But whether it's cause or effect, isn't clear. (Chen, 10/27)

San Jose Mercury News:
Marijuana Use Linked To More Frequent Sex, Says Stanford Study
A major new Stanford University study shows a link between marijuana use and sexual desire, suggesting that there may be science behind the age-old practice of using the drug as an aphrodisiac. The groundbreaking analysis of the lifestyles of more than 50,000 American men and women stops short of recommending pot to spice up your sex life. Scientists stress that the study, published Friday in the Journal of Sexual Medicine, doesn’t necessarily show that toking leads to more and happier sex. (Krieger, 10/27)

The CT Mirror:
Administration Warns Of Flaw In Hospital Tax
The administration of Gov. Dannel P. Malloy warned legislators Wednesday of a flaw in the bipartisan budget’s hospital tax provision that could open a $1 billion gap in the two-year spending plan, a message coolly received by lawmakers in a mood to celebrate an end to the state’s long budget impasse. House Majority Leader Matt Ritter, D-Hartford, and House Minority Leader Themis Klarides, R-Derby, said the House would not postpone final passage of the budget already approved by the Senate, because they could correct any errors in supplemental legislation. (Pazniokas, 10/26)

Health News Florida:
Health Centers Weigh Funding Changes
Florida health care officials are offering $50 million to federally qualified health centers to help offset the costs of care they will provide to poor residents in the coming year. It's more money than the centers — which usually provide primary care in communities --- have ever been offered under the state's long-running Low Income Pool, or LIP, program. (10/26)

Reuters:
Federal Judge Strikes Down Two Abortion Restrictions In Alabama
A U.S. judge on Thursday struck down two abortion restrictions in Alabama that limited how close clinics can be to public schools and banned a procedure used to terminate pregnancies in the second trimester. The decision is a blow to abortion opponents in Alabama, who have joined conservatives in other states in enacting new laws that critics said were chipping away at the U.S. Supreme Court's 1973 Roe v. Wade decision legalizing abortion. (Kenning, 10/26)

Chicago Tribune:
Parents Of Dead, Dying Children Blast Public Health Director For Newborn Testing Failure
Speaking publicly for the first time about his department's decadelong failure to begin screening babies for a deadly disease, Illinois Public Health Director Nirav Shah told state lawmakers on Wednesday, "It's unacceptable and shameful that it's taken this long." With parents of dead or dying children seated behind him at the state Capitol, Shah took a lashing from Rep. Mary Flowers, who called a hearing in response to the Tribune's special report "Doomed by Delay." The report exposed bureaucratic missteps that robbed those families of the chance to save their children from Krabbe disease, a devastating neurological illness that can only be treated if caught in the first days of life. (Callahan and Long, 10/26)

The Washington Post:
Judge Blasts District Agency For Treatment Of Defendants With Mental Illness
A D.C. Superior Court judge Thursday threatened to hold the District agency charged with overseeing mental-health services in contempt for failing to provide a defendant with a court-ordered psychological evaluation. Judge Milton C. Lee called the hearing after a woman who was arrested and accused of simple assault with a knife was sent away after she showed up at the courthouse for the scheduled Oct. 17 evaluation. (Alexander and Silverman, 10/26)

Health News Florida:
$5 Million A Year Proposed For Health Care Generators
A House Democrat on Wednesday proposed offering $5 million a year in matching grants to help health-care facilities add backup power systems. Rep. Larry Lee Jr., D-Port St. Lucie, filed the proposal (HB 435) for consideration during the 2018 legislative session, which starts in January. It comes after Hurricane Irma on Sept. 10 knocked out the air conditioning system at The Rehabilitation Center at Hollywood Hills, a Broward County nursing home. Eight residents of the sweltering nursing home died Sept. 13, and six others died subsequently after being evacuated. (10/26)

Arizona Republic:
Have You Gotten Your Flu Shot? First Cases Have Been Confirmed
It's not too soon to get your flu shot. The Arizona Department of Health Services reports that 92 flu cases were officially confirmed statewide through Oct. 21, with 54 of those cases confirmed just last week. In Maricopa County, there were 20 cases confirmed between Oct. 1-14, with eight of those in the second week of that period, according to the Maricopa County Department of Public Health's website. (Marsh, 10/26)

Sacramento Bee:
Chelsea Roman: 10 Sacramento-Area Residents Step Up To See If They’re A Kidney Match
Ten Sacramento-area residents – nine women and one man – say they are willing to be tested to see whether their kidneys might be a match for Chelsea Roman, a 32-year-old Sacramento woman whose kidneys are failing. “It’s just so incredible. I’m shocked,” Roman said, when The Bee told her about the response. “When my sister told me she spent yesterday making phone calls, I was brought to tears.” (Anderson, 10/26)

The Oregonian:
Oregon Council Reluctantly Greenlights Lead Testing At Day Cares
Under political and public pressure, Oregon's Early Learning Council on Thursday reversed itself and adopted a new policy to eventually require day cares to test drinking water for high levels of lead. The council in September unanimously adopted a plan that did not require lead testing for more than 4,000 licensed day cares that oversee more than 100,000 children. Council members said the costs would be too burdensome for day care providers. (Schmidt, 10/26)

Columbus Dispatch:
Columbus Files Lead-Paint Cases Against 13 Homes
Columbus officials have filed 13 cases against property owners who have not removed lead paint from their properties even after Columbus Public Health officials ordered them to do so and marked the properties with warnings. All the properties are occupied, either by owners or renters. (Viviano and Ferenchik, 10/26)

San Francisco Chronicle:
Lead Contamination Found In Water At 7 Oakland Schools
Children at an Oakland elementary school have been exposed to water with lead levels four times higher than allowed under federal guidelines, test results obtained Thursday by The Chronicle show. The temporary site of Glenview Elementary School near the Emeryville border was one of seven sites in the Oakland Unified School District where contamination levels of the toxic metal in water exceeded federal health standards. The district began testing school taps in August in advance of new state requirements, but the results have not been well-publicized. (Tucker, 10/26)

California Healthline:
California Cracks Down On Weed Killer As Lawsuits Abound
Jack McCall was a fixture at the local farmers market, where he sold avocados and other fruits he grew on his 20-acre ranch in Cambria, on California’s Central Coast. The U.S. postal worker and Little League coach was “very environmentally friendly,” said Teri McCall, his wife of 41 years. He avoided chemicals, using only his tractor-mower to root out the thistle and other weeds that continually sprouted on the flat areas of the ranch. (O'Neill, 10/26)

The Commonwealth Fund:
Medicaid Payment Reform 10 Expansion States
States have made health system reform a core element of their Medicaid expansions, with the aim of improving access, quality, efficiency, and population health. States have sought to incorporate evidence-based practice and payment strategies, with an emphasis on populations likely to benefit from improved care management and on better integration of treatment for physical and behavioral health problems. Seven of 10 are directly engaged in provider payment and delivery system reform. Agencies noted the importance of experienced provider networks in addressing complex health and social needs, along with managed care’s role in quality improvement and payment reform. (Rosenbaum, Schmucker, Rothenberg et al, 10/25)

Jama Dermatology:
Tanning Salon Compliance In States With Legislation To Protect Youth Access
In this cross-sectional telephone survey of 427 tanning salons in 42 states and the District of Columbia, 159 tanning salons were out of compliance with state legislation. Statistically significant decreases in compliance were found for rural, independently owned, and southern US tanning salons. Tanning salon compliance with state laws restricting access to minors is unsatisfactory, and monitoring and enforcement efforts are needed to ensure compliance with these laws that are intended to minimize the harmful effects of UV tanning in minors. (Williams, Buhalog, Blumenthal et al, 10/25)

JAMA:
Robotic-Assisted Vs Conventional Laparoscopic Surgery For Rectal Cancer
Among patients with rectal adenocarcinoma suitable for curative resection, robotic-assisted laparoscopic surgery, as compared with conventional laparoscopic surgery, did not significantly reduce the risk of conversion to open laparotomy. These findings suggest that robotic-assisted laparoscopic surgery, when performed by surgeons with varying experience with robotic surgery, does not confer an advantage in rectal cancer resection. (Jayne, Pigazzi and Marshall, 10/24)

Health Affairs:
Emergency Department Visits For Firearm-Related Injuries In The United States, 2006–14
Firearm-related deaths are the third leading cause of injury-related deaths in the United States. Yet limited data exist on contemporary epidemiological trends and risk factors for firearm-related injuries. Using data from the Nationwide Emergency Department Sample, we report epidemiological trends and quantify the clinical and financial burden associated with emergency department (ED) visits for firearm-related injuries. (Gani, Sakran and Canner, 10/12)

Opinion writers offer their ideas about whether President Donald Trump's declaration can have a meaningful impact on the nation's effort to address the problem.

The Washington Post:
Forget Trump’s ‘Public Health Emergency.’ Real Action On The Opioid Crisis Is Coming From The FDA.
The Trump administration has so far completely botched the national response to the opioid epidemic. More than two months after President Trump described the epidemic to reporters as a “national emergency” and a week after Trump promised to declare it so, the White House stopped short of that designation. Instead, it opted to declare a “public health emergency,” waiving some health-care regulations for states and promising other initiatives in the weeks to come. (Robert Gebelhoff, 10/26)

The New York Times:
Words, Not Action, From Mr. Trump On Opioids
President Trump’s brother died an alcoholic, so it’s hard to dispute that Mr. Trump understands the horrors of addiction. But in what was billed as a major speech on Thursday, Mr. Trump demonstrated that he has not grasped what’s needed to combat the opioid problem and, more important, the ways in which his own policies impede recovery for millions of Americans. (10/26)

Bloomberg:
What Trump Missed On Opioids
In sweeping if vague terms, President Donald Trump on Thursday declared opioid addiction a "national health emergency." What he didn't do is talk about one of the most effective ways to address it -- or how much it would all cost. (10/27)

The Wall Street Journal:
The Opioid Puzzle
President Trump has now declared opioid addiction a national “public health emergency,” a political formality for a crisis that has wrecked lives and families across America. The Trump Administration’s move is a moment to consider what the government can do to treat a social ailment that so far has resisted effective treatment. (10/26)

The Washington Post:
The Opioid Crisis Isn’t Limited To White Americans In Rural Pro-Trump Counties
After promising to do so this past summer and speaking about it repeatedly on the campaign trail, President Trump declared the opioid crisis a public health emergency Thursday. He discussed the magnitude of the drug problem in a speech at the White House.“ Addressing it will require all of our effort, and it will require us to confront the crisis in all of its real complexity,” he said, joined by first lady Melania Trump and New Jersey Gov. Chris Christie (R), chairman of a presidential commission on combating the crisis. (Eugene Scott, 10/26)

RealClear Health:
Want To Help An Addict? Call The Cops.
Last month, the Centers for Disease Control and Prevention released data on drug-related deaths in the United States in 2016. The numbers are staggering. Approximately 64,000 people died of overdoses, a 22 percent increase over 2015. More than 60 percent of deaths involved opioids, a class of extremely addictive drugs that include pain medications like Percocet, Vicodin and OxyContin, as well as heroin. (Roger D. Klein, 10/26)

The Wichita Eagle:
Helping Families Relaunch Their Lives
Too often we have heard a judge state from the bench: “You have chosen drugs over your children.” No parent would choose “drugs” over their children purposefully, but their addiction often seems their only relief. We have mentored these families and helped them complete their court orders and see their families return home. It is rewarding to see families ‘ReLaunch.” We have seen families living in their cars and heavily addicted to methovercome their addiction and have their children returned home. We have worked with over 100 families and while some of the parents had their parental rights terminated, many more were able to complete their court orders and have their children returned to the home. We have found that when you encourage families to work with the system and teach them parenting techniques, parents and children are not only reunited, but are better. (Michael O' Donnell, 10/27)

Editorial pages offer different perspectives about how to proceed in addressing the current and future challenges faced by the Affordable Care Act's individual insurance market.

The Wall Street Journal:
Health Care Needs A Bipartisan Fix
President Trump has asked for a bipartisan short-term solution to reduce health-insurance premiums and avoid chaos in the individual market so 18 million Americans won’t be hurt. Last week, 12 Republican and 12 Democratic U.S. senators proposed a solution. After eight years of ObamaCare speeches and votes but zero legislative victories, our bill actually could make conservative ideas law. It would permanently roll back some restrictions on states and allow anyone to buy a lower-cost catastrophic plan. To achieve these conservative victories, we agreed to extend cost-sharing reduction payments for two more years. (Sen. Lamar Alexander and Sen. MIke Rounds, 10/26)

The New York Times:
How Republicans Can Make A Deal On Health Care
A consensus is emerging on Capitol Hill about the need to appropriate funding for the Affordable Care Act’s cost-sharing subsidies, which help working-class Americans buy health insurance. But there are plenty of areas of disagreement, especially among Republicans. They can’t decide, having agreed to continue the subsidy payments, what changes should accompany them. (Lanhee C. Chen, 10/27)

Bloomberg:
Soaring Premiums Mean Soaring Risks For Obamacare
Avalere cites a number of factors that are driving up premiums. Many are the same problems we’ve been seeing for years, the product of bad program design: lower-than-anticipated enrollment in the marketplace and limited insurer participation. Some are a result of policy uncertainty: not knowing exactly what the government is going to do about Obamacare, insurers want to hedge their bets, so they don’t lose a fortune if the Trump administration suddenly decides to take off in a new direction. And then, of course, there are the CSR payments. (Megan McArdle, 10/26)

The Wall Street Journal:
A Talcum Powder Tort Blowout
Plaintiff lawyers are hoping to make talc torts the next asbestos racket, but their dreams of mega-payoffs may have been shattered last week when a judge in California tossed a $417 million jury award against Johnson & Johnson. The case was brought by a 63-year-old woman with advanced ovarian cancer who had used baby powder for more than 40 years. She claimed the talc caused her cancer and that J&J knew the product was carcinogenic but failed to warn consumers. A Los Angeles jury in August awarded the plaintiff $70 million in compensatory and $347 million in punitive damages. (10/26)

RealClear Health:
FDA Can Help Vulnerable Patients Take 'Last-Resort' Medications
Imagine you're diagnosed with a rare cancer. There are no FDA-approved treatments. But after frantically searching the internet, you discover hopeful news – a pharmaceutical company is developing a possible cure. Unfortunately, the drug is in the early stages of development. It's not FDA approved – at least not yet. There's no guarantee the medicine will work. ... The good news is that under current law, you could petition the company for permission to try the experimental drug. If the company agrees, you would then have to seek permission from the FDA. Some members of Congress believe the FDA should be taken out of the equation. ... Lawmakers' hearts are in the right place. But they're misinformed. The FDA doesn't delay the process – and cutting out the agency would be dangerous. (Peter J. Pitts, 10/25)

The Charlotte Observer:
Guess Which State Stands Out For Its Votes Against Hurricane Maria Relief
President Trump on Thursday signed a $36.5 billion disaster bill to pay for damage caused by the floods, hurricanes and fires of the past months. Of this amount $6.3 billion will be used to salvage Puerto Rico from the wreckage of Hurricane Maria. ... What is unusual is that the North Carolina congressional delegation cast the most nay votes of any state. Ninety thousand Puerto Ricans reside in North Carolina, making it the state with the 12th largest Puerto Rican population. ... sometimes humanity outweighs fiscal probity. More than a month after Hurricane Maria struck Puerto Rico, the families of North Carolinians are still lacking shelter, food and medical care. (Gretchen Sierra-Zorita, 10/26)

Los Angeles Times:
He Violated His Probation. Now He Can't Give His Child A Kidney
A.J. Burgess was born without kidneys. He spent the first 10 months of his life in a hospital in Atlanta. At 2 years old, he weighs only 25 pounds and has yet to take his first steps. He receives dialysis treatment daily and his health could take a fatal turn at any moment. One can only imagine the suffering his parents must be going through. Luckily, A.J. is finally old enough that a kidney transplant is now an option. With a transplant he could have a normal childhood and live a long, healthy life. A.J. is even luckier because his father, Anthony Dickerson, is a perfect match. Dickerson is willing and able to save his son’s life — but he is not permitted to do so. (Glenn E. Martin and Joshua Morrison, 10/27)

Stat:
It's Time To Lift Restrictions On Studying Gun Violence And Its Prevention
When a fatal disease becomes increasingly common, scientists along with public health and government officials sound the alarm and try to identify what is causing the disease, how it spreads, and how to prevent it. Why aren’t we taking a similar approach with mass shootings, which are a similar sort of public health issue? (Dominik Wodarz and Natalia L. Komarova, 10/26)

Stat:
In The Intersex Community, We Need Quality Care. Doctors Aren’t Listening
I sometimes had a tough time with doctors before I found out — at the age of 41 — that I was intersex and that my true medical history had been hidden from me for decades. Now that it’s out in the open, I still can’t find knowledgeable doctors to help me. ... I’m not alone. Hundreds of intersex people have shared similar stories with me in person, at conferences, or on social media. As a friend recently lamented on Facebook, “I read a ton of medical journals and peer-reviewed papers. It’s the only way for the intersex community to be informed, so we in turn can inform our doctors and nurses.” (Kimberly Zieselman, 10/26)